“I have been lost in a daydream for as long as I can remember….These daydreams tend to be stories…for which I feel real emotion, usually happiness or sadness, which have the ability to make me laugh and cry…They’re as important a part of my life as anything else; I can spend hours alone with my daydreams….I am careful to control my actions in public so it is not evident that my mind is constantly spinning these stories and I am constantly lost in them.”

The 20-year-old woman who emailed these reflections to Eli Somer at the University of Haifa, Israel, diagnosed herself with Maladaptive Daydreaming, sometimes known as Daydreaming Disorder. While Maladaptive Daydreaming is not included in standard mental health diagnostic manuals, there are cyber-communities dedicated to it, and “in recent years it has gradually become evident that daydreaming can evolve into an extreme and maladaptive behaviour, up to the point where it turns into a clinically significant condition,” write Somer and Nirit Soffer-Dudek at Ben-Gurion University of the Negev, in a new paper on the disorder, published in Frontiers in Psychiatry.

This study is, they say, the first to explore the mental health factors that accompany Maladaptive Daydreaming (MD) over time – and it provides insights into not only what might cause these intense, vivid, extended bouts of daydreaming but also hints at how to prevent them, or how to stop them in their tracks. Because while many people who experience MD report enjoying their daydreams at the time, MD can also negatively affect their relationships with others, their day-to-day lives, and their overall emotional wellbeing.

Earlier work led researchers to suggest that MD might be either a dissociative disorder, a disturbance of attention, a behavioural addiction or an obsessive-compulsive spectrum disorder.

For the new online study, Somer and Soffer-Dudek recruited 77 self-diagnosed sufferers of MD, from 26 different countries, ranging in age from 18-60. Just over 80 per cent were women (possibly because women seem to be more affected by MD than men, the researchers write).

The participants first provided details about any mental health diagnoses (21 had been diagnosed with depression, 14 with anxiety disorders and 5 with OCD, among other disorders). Then, each evening before bed, for 14 days, they completed a series of questionnaires that asked about their experiences that day. These scales assessed levels of dissociation, obsessive-compulsive symptoms, depression, general anxiety, social anxiety, and emotion – and also maladaptive day dreaming. (Participants were asked to report on the extent to which statements such as “I felt the need or urge to continue a daydream that was interrupted by a real-world event at a later point” had applied to them that day.)

On average, participants reported spending four hours a day daydreaming. On days on which their MD was more intense and time-consuming, they also experienced higher levels of obsessive-compulsive symptoms, dissociation and negative emotion, and both types of anxiety. But only obsessive-compulsive symptoms consistently predicted the intensity and duration of maladaptive daydreaming on the next day, regardless of the levels of obsessive-compulsive symptoms on that following day.

Despite these findings, the researchers note that only five of the participants had actually been diagnosed with OCD – “This discrepancy suggests that obsessive-compulsive symptoms and MD share common mechanisms and interact with each other…but MD does not seem to be merely a subtype of OCD.” However, they added that many people with MD describe being consistently drawn to their daydreaming in a compulsive way. “The finding that a surge in obsessive-compulsive symptoms precedes MD [also] points to a key role of this construct as a contributing mechanism,” Somer and Soffer-Dudek argue.

Compulsions to daydream, or to carry on daydreaming even after many hours have passed, might be addressed using cognitive behavioural approaches developed to address other compulsions, the researchers suggest. They also speculate that low levels of the neurotransmitter serotonin may play a role in MD, as in OCD. If future work confirms this, drugs that modify serotonin levels may possibly be used in treatment.

There were some limitations of the study – in particular, that it was based entirely on self-reports. But as research on MD is scarce, and this is thought to be the first longitudinal exploration of the disorder, the results should at least help to inform future work in this area. Though it’s also possible that not all people with MD will want treatment. As the woman with MD who emailed Somer also wrote: “I am torn between the love of my daydreams and the desire to be normal.”

Why is removing yourself from ‘real life’ maladaptive? When you don’t have the power to change that life for the better can you think of a better coping strategy? When people get overly stressed by things they cannot do anything about, they often choose to enter and construct an alternative reality where they are in control. Don’t take my word for it. Watch ‘Life of Pye’ or talk to any schizophrenic about their ‘alternative realities’ if you want to understand why this is an adaptive not maladaptive behaviour from their perspective.

It’s been a few weeks since you posted this comment but I saw you hadn’t received an answer so thought I’d step in, as an MD sufferer myself.

I think it’s important to clarify that what you’re talking about in your comment, about ‘removing yourself from real life’, is more akin to something actually often referred to as Immersive Daydreaming. This is when it is the person’s choice to daydream, whether for enjoyment, escapism, or whatever the reason might be. However, the important word there is ‘choice’. With MD, there is no choice; it has become an addiction.

Daydreaming is perfectly normal, everyone does it, but most people will daydream for a couple of minutes, maybe a little longer if they have the time. However, with MD, you can find yourself slipping into a daydream without realising it, and then be in that daydream for hours; when you’re losing hours out of every single day you soon find yourself running into problems with work, with school etc.

Also, after a while of doing this, reality really starts to pale in comparison and you don’t want to stop; you need to keep daydreaming to get that fix because why would you stop when it seems so much more exciting than your real life is?

Like you said, constructing an alt reality is common for people to de-stress in, but when you start to place that alt reality on a pedestal and see it as better than real life, that’s when it becomes a problem. You stop going out and lose social connections, because you convince yourself that your daydreams are far more exciting (even though you know they’re not real) and so you become addicted to that feeling.

In the long term though, it just makes things worse and worse; you lose, literally, days/weeks/months of your life to daydreaming (which is, essentially, doing nothing at all) and you can’t control it. That’s when it becomes maladaptive.

tl;dr

It starts off adaptive, and a seemingly reasonable response to the fight or flight reflex, but becomes maladaptive when it morphs into an addiction, you lose control of it, and can’t even stop when it starts negatively impacting your entire life.

The other issue about Maladaptive Daydreaming is, aside from it not being a choice and having that control taken away from them by the condition in itself, the daydreaming interferes with things like eating and sleeping, and basic necessities of living a live, that’s what puts the Maladaptive in MD, otherwise yes it is merely an Immersive pleasurable experience.

Most medical professionals that do research in this area do look for underlying causes and it seems that for the most part Maladaptive Daydreaming is a side-effect of another issue, often Anxiety of Obsessive/Compulsive Disorder. From my own googling and other sources, it seems valid for the most part, and anecdotally at least a medication called Prozac has not only been functional for people with Anxiety/OCD issues, but it also brings their MD symptoms under control – in those that experienced MD as well. Please note I am not a Medical Professional myself and I suggest that you do your own research and take it to a competent Doctor that you trust before going on any kind of medication, they should be able to give you information about dosages, other possible conditions going on, whether or not you have any other conditions that prevent you from taking that particular chemical among other issues…

Well described. Also, MD has a devastating effect on two important functions in life, such as it deteriorate your memory and makes you loosing motivation for real life. And, you just wake up from it very exhausted and in long term, it really becomes a pathological issue.

It’s not adhd. This is coming from someone who suffers with md. I’ve spoken to several mental health professionals who’ve assured me this is a separate issue caused by past trauma. Please dont make assumptions.

As with everything else in clinical psychology, any seemingly harmless behaviour becomes maladaptive when it interferes with your goals and day to day activities. The line between adaptive and maladaptive daydreaming is blurred.